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Drug-free remission of AIDS in monkeys: from anecdotal reports towards a globally scalable strategy. Last week's reports of patients possibly "cured of AIDS" have fueled the hope for an end of this epidemics, although the strategy adopted cannot be scaled to the 33 million living with HIV/AIDS worldwide. However, another important step in this direction, that is the development of a scalable strategy able to induce a drug-free remission of AIDS in monkeys, is finally in the pipeline...

Last week's reports of patients possibly "cured of AIDS" have fueled the hope for an end of this epidemics, although the strategy adopted cannot be scaled to the 33 million living with HIV/AIDS worldwide.

However, another important step in this direction, that is the development of a scalable strategy able to induce a drug-free remission of AIDS in monkeys, is finally in the pipeline, researchers report in Retrovirology, one lead scientific journal in the field.

Apart from rare cases of drug-free remission obtained treating very early with regular antiretroviral therapies, a cure for AIDS has been so far obtained only in Mr. Timothy Brown, i.e. the "Berlin patient", and, possibly, in two other recently reported cases in Boston. In all these patients, who also suffered from hematological malignancies, invasive and life-threatening techniques have been applied to remove the blood cells (including those harboring the virus) and replace them with new virus-free and cancer-free cells. Therefore, novel strategies are needed that be both safe and scalable to the 33 million people living with HIV/AIDS worldwide.

Now, by adding to antiretroviral therapy two existing drugs, i.e. the gold salt auranofin and the chemosensitizing agent buthionine sulfoximine (BSO), an Italian and American research team, led by Dr. Andrea Savarino at the Italian NIH (www.iss.it), observed, after therapy suspension, a drug-free remission of the disease in the macaque AIDS model (i.e. the animal model most closely resembling human AIDS).

The drug combination safely and gradually replaced the "diseased" white blood cells with fresh and efficient cells, although, at first, it did not prevent the initial viral rebound after therapy suspension. "However", says Dr. Andrea Savarino, "during the subsequent follow up of the macaques, the new immune cells fought back the virus, rescuing the macaques to healthy conditions reminiscent of a drug-free remission of AIDS". "It's been the most exciting finding in my entire life", he concludes. “It turns out that a specific branch of the immune system is boosted by the addition of BSO to the drug cocktail, possibly mimicking an auto-vaccination against the virus”, adds Iart Luca Shytaj, a collaborator of Dr. Savarino and first author of the article published in Retrovirology.

the new immune cells fought back the virus, rescuing the macaques to healthy conditions reminiscent of a drug-free remission of AIDS

Dr. Savarino's team is planning to start a clinical trial early in 2014.The location and timing of the clinical trial will be announced at the biennial conference on "HIV persistence during therapy" to be held in Miami next December and bringing together the world's top experts in the field.